What is a nephrostomy?

A nephrostomy is a procedure to drain urine from your kidney using a catheter (tube). Urine normally drains from your kidneys into your bladder through small muscular tubes (ureters). Tests have shown that one or both of your ureters has become blocked.

What are the benefits of a nephrostomy?

You should have less risk of your kidney being damaged without having to have surgery. Your doctor will have time to find out why your ureter is blocked and to treat the problem.

Are there any alternatives to a nephrostomy?

Sometimes the problem can be treated by stents (tubes) or surgery. However, this can take time and a nephrostomy will help your kidneys to carry on working.

What will happen if I decide not to have a nephrostomy?

Your kidney can become permanently damaged.

You can live a normal life with only one working kidney. However, if both your kidneys are affected, or you have only one kidney that is working, you will probably get kidney failure.

You will need regular dialysis or a kidney transplant.

What does the procedure involve?

A nephrostomy usually takes less than 30 minutes but can take up to 45 minutes if the procedure is difficult.

Your doctor will insert the catheter in your kidney using a needle and guidewire (thin flexible wire). They will inject local anaesthetic into the area where the needle will be inserted.

When your doctor is satisfied that the needle is in the right position, they will replace it with the catheter. The catheter will be attached to a plastic bag to hold the urine.

What complications can happen?

The healthcare team will try to reduce the risk of complications.

Any numbers which relate to risk are from studies of people who have had this procedure. Your doctor may be able to tell you if the risk of a complication is higher or lower for you.

Some risks are higher if you are older, obese, you are a smoker or have other health problems. These health problems include diabetes, heart disease or lung disease.

Some complications can be serious and may even cause death.

• Bleeding. If the bleeding is heavy, you may need another radiology procedure, a blood transfusion or even surgery.
• Infection in your kidney or in the space around your kidney. The risk is higher if there was already an infection in your kidney.
• Allergic reaction to the equipment, materials or medication.
• Making a hole in nearby structures with the needle.
• Leaking urine.
• Failed nephrostomy. Sometimes your doctor is not able to insert the catheter in a good enough position in your kidney.
• Blocked nephrostomy.
• Radiation exposure.

How soon will I recover?

You will need to stay in bed for at least a few hours to recover and rest.

The catheter will need to stay in place until the cause of the blocked ureter has been treated.

Usually you will need to stay in hospital overnight. Sometimes you can go home the same day.

If you go home while the catheter is still in place, the healthcare team will show you how to look after it and change the bag.

Summary

A blocked ureter is a serious condition. A nephrostomy is usually a safe and effective way of draining urine from your kidney to give your doctor time to find out why your ureter is blocked and to treat the problem.

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